| NPI | 1982877320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: IN 07001089A) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IL 016.005331) |
| 213ES0131X (Licence: IN 07001089A) | |
| Enumeration Date | 2008-04-07 |
| Last Update Date | 2025-05-22 |